HomeMy WebLinkAbout113 Reel Ctf,
Permit # : �� —
Job Address: Q�
Description of Work: T—t —
Historic District:
tN -
CITY OF SANFORD PERMIT APPLICA'
Date: _
L 3
Zoning: Value of Work: $ X
PAl/0St
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole z
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial `
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: _� # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
—�� rNn , — ten — —- 'rii1
Parcel #: W I 0 V 01
Owners Name & Address:
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer:
Address:
Contact Person:
State License Number:
Phone:
Fax:
93
ne: iso%'_ �'3Z-32.00
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of
this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptanc it is verification that I 1 n ify twwr of the property of the requirements of Florida Lien Law, FS 713.
&ig'hature of Owner/Age t Date ire of C ntj J*/Agent 1 Date
t--1 A— e) tr ,. /A n rt w.n
Print
Sign fu o'ftfoiary-State f �rida // Date
��►ar Po,` atheri M rtinez j !/////
r -t ' o fission DD019306
'1,.' 4-0' Expire I 1
Owner/A9g?-9P1S PersQna�llll h���oY'lm ta.Me�°r �9 p
Produced IDC C)l—-lL7`f� - �! °S • 740S 0
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Specia! Conditions:
S' �tM} -6M%' aFy- tae iffjx'1 i a Date
^o Katherine Martinez
v My Commission DD019306
Contractor/Agent is / Person a]y`tnovn01to'MAeMlr19.2005
Produced ID
Zoning: Utilities: ITD:
(initial & Date) (Initial & Date) (lr>itial & Date)
0-9
LIMITED POWER OF ATTORNEY
19 z7�m�
Date
! hereby name and appoint Sj�tove Seo
Of RoofMaster of Central Florida Inc.to be my Lawful attorney
In fact to act for me and apply to for
a Roofing permit for work to be performed at a location
described as
Section Township
Range
Lot
9
Block
Subdivision
Z
(Address jaf Job)
-s- Ile
(Owner of Property and Address)
w f � d1/e.
and to sign my name and do all things necssary to this appointment.
Jimmy W. Wrye CCCO27432
(Type or Print name of Certified Contractor, License #)
Signatur o Certifie�Con�traor�
Acknowledged.-
Sworn
cknowledged:Sworn to and subscribed before me this. da of be � d � Y �-�I �-p V `—
A.D. 20 by Jimmy Wayne Wrye who is rsonally known to me.
Katherine Martinez
My Commission DD019308
Si n at r %o d� Expires April 19, 2005
SEAL
Permit Number '
Par061 cientificatlon Number
Prepared by:
Return to: Roof Master of Central Florida Inc.
1904 W. Colonial Drive
Orlando, FL 32804
407-872-3200
www.roofmastar-ct.com
NOTICE OF COMMENCEMENT
State of
County of � o (co 07—P
i 1 III It Iii II 681 [! til II 111 III 11819 til 11ill 11 ill MIM lit 1 lis
MARYANNE MORSE, CLERK OF CIRCUIT COURT
SEMINOLE COUNTY
BK 05495 PG 1355
CLERK'S # 2004165952
RECORDED 14/27/2004 08:47:34 AM
RECORDING FEES 10.00
RECORDED BY t holden
T`IFIE,A COPV,
`,WARYANNE MOR
:ikL0K OF CiKUll MUR--1
ned hereby -call
The undersi
9 y gives notice that improvement(s) will be made to -¢2r1
with Chapter 713, Florida Statutes, the following information Is provided in the
1. Descri tion of property (legal- description of the property, and street
113-e
So����,�� F2- 3
2. General description of Improvement(s)
i
3. Owner Information j
1'l
!dITJS l,yM[
property, and in accordance
of%Co�m� m?enncpement.
vailabPA4
Name rat 4y c c r i Telephone Number y0'%
Address S(,- vv` ,, 0. 5 b o j Fax Number
Interest in Property:
4. Fee Simple Title Holder (if other than owner shownabove)
Name Telephone Number
Address t Fax Number
5. Contractor
Name
Address /94V a -V
t6. Surety (if any)
Name
Address
7. Lender (if any)
Name
Address
8. Persons within the State of Florida designated by
served as provided by §713.13(1)(a)7., Florida St
Name
Address
9. In addition to himself or herself, Owner designates
provided in §713.13(1)(b), Florl8a Statutes.
Name
Address
10. Expiration date of notice of commencement (the
unless a different date is specified):
Date Signed(/ ign I 1 of Owner Note�Ser §713.13(1)(9), "owner
must, sign ...and no one else may be permitted to sign in
his or her stead."
elephone Number 40-7-�7z zoo
ax Number >- -?;'2-
phone
?7Z
phone Number
Number
unt of bond $
phone Number
Number
i whom notices or other documents may be
phone Number
Number
rg to receive a copy of the Lienor's Notice as
phone Number
Number
date Is one year from the date of recording
Sworn to and subscribed4 for me Yhis(30 day of
wno is personally known to me OR
as identification.
:f
Form Revised: 12100 for 19_ to 20_
by
Sign r"f-mmry (nof r14Lsbal to �
, ppear below)
I/
�I
�YP�e Katherin Martinez
G
" My Commission DD019306
Expires April 19, 2005
I
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